Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 21038 | TX |
NPI | 1053334136 |
---|---|
Provider Name | Dr. Edith Rojas |
First Address | Corpus Christi, TX 78413-2904 |
Second Address | Corpus Christi, TX 78413-2904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 30/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1590374-02 | (05) | TX |